ObGyn/Pregnancy issues/Separated abs

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Question
I have a 3 finger seperation of my abs.  I have been pregnant 4 times.  My last pregnancy was with twins each weighing 8lbs at birth.  My twins just turned 3.  I am at my pre pregnancy weight.  However, my stomach sticks out like I am 5 months pregnant.  I workout for 1 1/2 hours 6 times a week.  I have tried using a personal trainer and nothing helps.  I gave always been able to have a flat stomach in the past but nothing works now.  I'm desperate.  I hate the way I look. People ask me if I'm pregnant all the time.  Do I need a tummy tuck or is there something I can do that I haven't tried that would help?  I'm very motivated and dedicated.  
Thanks,
Katherine

Answer
Katherine,
Sorry to take so long to get back to you.
Lots of women, both with and w/o diastasis, end up with overly round, protruding abdominal walls. Total bummer. Nothing is worse than folks brightly asking when the baby is due, when you're not pregnant! And it makes sense that you would experience this, after 4 pregs, with the last being twins, which stretches out the abdomen a lot more than a singleton.
But it is definitely fixable with proper exercise.
This postpartum problem occurs when the external abdominal muscles, the Rectus Abdominis, and the External Obliques are a lot stronger than the deepest abdominal muscle, the Transverse Abdominis, or Tva. Sometimes the TvA can become quiescent (not engaging when it should) or is too weak to supply enough stability (through abdominal compression) to maintain a flat abdominal profile when performing abdominal exercises. Or it can be a matter of engrained neuromuscular patterning too, especially if you've done a lot of traditional abdominal exercises like crunches before you rehabbed your TvA. Or a combination of these factors might be in play.
To remodel the shape of your abdomen, you need to start doing exercises that isolate and strength the Tva, and then when you've built up a foundation of strength, progress to exercises that train the TvA to function properly as a stabilizer. And stop doing all ab exercises that lift/roll the upper body off the floor of against the force of gravity.
At 3 years post childbirth, you should be able to partially close you mid line. I'd guess to around 2 finger-widths.
For more info on this, see pages:
http://befitmom.com/diastasis_recti.html
http://befitmom.com/abdominal_reconditioning.html  

ObGyn/Pregnancy issues

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Helene Byrne

Expertise

I can answer all questions regarding prenatal and postpartum fitness and exercise. I will not answer any questions that are not related to prenatal and postpartum fitness and exercise. I will not answer questions regarding getting pregnant, or signs or symtoms, only fitness and exercise during and after pregnancy. No due dates, medical problems during pregnancy, signs or symtpoms of pregnancy, pregnancy tests, vaginal problems/smells/discharge, periods or ovulation.

Experience

Pre-and-Postnatal Exercise Specialist ACE certified Personal Trainer Author: "Exercise After Pregnancy: How to Look and Feel Your Best" Book Author: "Bounce Back Fast! Post Natal Core Conditioning" DVD Founder: BeFit-Mom Teacher: Post Pregnancy Exercise Workshops

Organizations
IDEA Health and Fitness Association

Publications
numerous regional parenting magazine

Education/Credentials
Dancing Thru Pregnancy, Pre/Post Natal Exercise Specialist Certification 2000 Resist-a-Ball Core Program, 1999 American Council on Exercise, Personal Trainer Certificate, 1999 Peak Performance, San Francisco, CA, Pilates Instructor Training Program, 1992 Health and Fitness Institute, Cal State Hayward, Personal Trainer Certificate, 1990 American College of Sports Medicine, Group Exercise Leader, 1989 Boston Conservatory, BFA/Dance, 1982

Awards and Honors
´┐ŻBounce Back Fast! Post Natal Core Conditioning´┐Ż, 2005. Winner of the Platinum Award from the Family Review Center, 2007.

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